Though they have not yet even begun high school, Lily, Fiana and Zuri have been diagnosed with gender dysphoria and will soon undergo medical intervention to prevent their bodies changing from that of boys to men.

Lily, 11, from the Austin area of Texas, has already begun taking hormone blockers to prevent her going through male puberty - a decision her parents wrestled with before undertaking.

“Around the age of two, Lily started asking for different types of toys, and then after that, the first big thing that we noticed was that she wanted to dress as Cinderella for Halloween,” Lily’s mom Julie Maerz told Barcroft TV.

“Right before her eighth birthday, she came out from her room one morning and she said 'I’m Lily all the time now, only use girl pronouns. I’m not gonna be Jack anymore’.”

Julie and her family had a lot of negative responses not only from strangers, but also from their family and friends.

“People come out of the wood work to let you know that you are harming your child by allowing her to be trans gender and it’s something that we’ve just come to expect and something that we really just rolls off our back at this point,” Julie said.

“Once you start to read the medical background of what gender dysphoria is and that it is a medical condition, it is not just a mental state.

"It is not something that is made up, when an eight year old tells you she is in the wrong body, she means it.”

Stacey Jefferson, 10-year-old Fiana’s mom, said she believed she just had a boy who liked girls toys until one evening when she was putting her then-son to bed.

“The stand out moment for me when I knew I really couldn’t spend another day with Fiana not transitioning was when we were getting ready for bed and she said ‘Mama, I need to tell you that I think I was supposed to be born a girl’,” Stacey said.

“I said ‘Honey, why do you think that?’ and she said ‘Well, I have a girl brain and a girl heart. All my toys are girl things and all my friends are girls. I don’t really understand the things that boys like to do’,”

"I knew right from that moment that I needed to raise her differently."

Kimberly Jones, whose daughter Zuri, 11, is also entering puberty as a transgender girl recalls the moment she knew she should allow her to transition.

“The first time we let her go shopping in a skirt, she was delighted. She was dancing around so happy, but also really nervous about what people would think or say."

“Now it’s like she has filled out with this whole persona of who she really is.”

While the three kids are well supported by their families, all three have encountered bullying outside of the home, especially from children at school.

Lily said: “From first to third grade is when I was bullied a lot. I was really sad going to school sometimes because I knew I would be teased or bullied.”

To fully transition during their teenage years, the three girls will take hormone blockers, then begin hormone replacement therapy around the age of 14 to 16, then have gender reassignment surgery when they are 18.

The youngsters describe how profound an effect having friends experiencing the same things as her has had on her young life so far.

“I'm glad that I have friends that actually understand what I am going through,” Fiana said.

"We immediately became friends, like, this person understands what I am going through, like, ‘Oh, my gosh! She is so nice and sweet and kind’, and I wanted to be her friend.”

Lily added: “I realised I’m not the only person who’s transgender. There are people out there who are like me.